Heartburn and reflux are common in pregnancy, but when acid repeatedly injures the esophagus you can get esophagitis — inflammation that causes pain, trouble swallowing, and sometimes bleeding. If you're pregnant and dealing with burning chest pain or food getting stuck, this guide explains why it happens, what you can try at home, and when to contact your OB or a gastroenterologist.
Two main things usually cause it. First, pregnancy hormones (especially progesterone) relax the lower esophageal sphincter, the valve that keeps stomach acid where it belongs. Second, as your uterus grows it pushes up on your stomach and increases reflux. If reflux is frequent, stomach acid can inflame the esophagus and lead to esophagitis.
Symptoms to watch for: burning or pressure behind the breastbone, pain when swallowing, the feeling that food is stuck, chronic cough or hoarseness, and in more severe cases vomiting blood or unexplained weight loss. Mild heartburn is common; pain that limits eating or breathing needs faster attention.
Start with simple changes that often help right away. Eat smaller meals and avoid lying down for 2–3 hours after eating. Raise the head of the bed by 10–15 cm (4–6 inches) or use extra pillows. Cut back on known triggers: spicy or greasy foods, citrus, chocolate, caffeine, and mint. Wear loose clothing around your waist.
Over-the-counter options that many pregnant people use include calcium carbonate antacids (Tums) for quick relief and sucralfate for healing in some cases — both are generally considered safe but check with your provider first. H2-blockers like famotidine (Pepcid) are commonly used when antacids aren’t enough. Proton pump inhibitors (PPIs) such as omeprazole or pantoprazole can be prescribed if reflux is frequent or severe; doctors often consider them when lifestyle changes and other meds fail.
Avoid NSAIDs like ibuprofen, since they can irritate the gut. Don’t start new prescription meds without telling your prenatal care team — your OB will balance risks and benefits and may consult a specialist.
If symptoms are severe, if you can’t swallow liquids, if you vomit blood, or if you lose weight, get medical care right away. Your doctor may order blood tests, an ultrasound for other issues, or an upper endoscopy in serious cases; endoscopy can be done during pregnancy when needed, with precautions to protect you and the baby.
Managing reflux early keeps you eating well and lowers the chance of complications like ulcers or strictures. Keep your care team in the loop, try the simple fixes first, and get prompt help for anything that feels off or severe. You don’t have to accept constant pain during pregnancy — there are safe steps to get relief.
